During today’s mark-up of the Senate Finance Committee health bill, Sen. Chuck Grassley (R-IA) offered an amendment requiring Medicaid enrollees to submit a government issued photo ID (“identification must be authenticated with the issuing agency,” the amendment states) with the application for coverage. Democrats defended the current birth certificate requirement, claiming that the amendment created an additional obstacle to coverage for lower-income enrollees who lack a photo ID. Some studies estimated that as many as 21 million American citizens don’t have such identification.
Sen. Jeff Bingaman (D-NM) called the amendment “a solution looking for a problem.” Binagman reminded Grassley that the majority of Medicaid fraud “is provider fraud,” not applicant fraud. “It is providers who are charging for services they are not providing,” Bingaman explained. Grassley responded by suggesting that his photo ID amendment would weed claims for people who are dead, leading Bingaman to point out that dead people can’t apply for coverage:
GRASSLEY: Medicaid is paying claims for people that are dead. So you know, photo ID and ‘are you alive?’ and all that is pretty darn important, it seems to me. […]
BINGAMAN: To the extent Medicaid is paying for people who are dead to get health care services, it’s not because people are applying for those services. It’s because providers are billing for services for people who are dead, and that’s the fraud we ought to stop.
Sen. Robert Menendez (D-NJ) reminded the committee that stringent verification requirements often do more harm than good, turning some citizens “into second class citizens.” The Wisconsin Department of Health and Human Services, for instance, reported that “nearly 33,000 individuals had their Medicaid denied or terminated because of the documentation requirement,” Menendez said. “In 62 percent of those cases, the sole reason for denial or loss of coverage was lack of identification. All of these individuals had provided documentation showing that they were citizens.”
The Baucus bill already includes verification requirements. Under the legislation, to obtain coverage within the Exchange, an applicant’s “name, social security number, and date of birth will be verified with Social Security Administration (SSA) data.” “For individuals who do not claim to be U.S. citizens but claim to be lawfully present in the United States, if the claim of lawful presence is consistent with Department of Homeland Security (DHS) data then the claim will be considered substantiated.”
Grassley’s amendment failed in a vote of 10-13.